Provider Network Manager (US)

Elevance Health•Atlanta, NY

10d•$69,048 - $86,310•Hybrid

About The Position

This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law The Network Services and Programs, Provider Network Mgr develops the provider network through contract negotiations (language and rates), relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms. Typically works with less-complex to complex providers. Providers may include, but are not limited to, smaller institutional providers, professional providers with more complex contracts, medical groups, physician groups, small hospitals that are not part of a health system, ancillary providers, providers in areas with increased competition or where greater provider education around managed care concepts is required. Contracts may involve non-standard arrangements that require a moderate level of negotiation skills. Fee schedules can be customized. Works with increased independence and requires increased use of judgment and discretion. May work on cross-functional projects requiring collaboration with other key areas. Serves as a communication link between professional providers and the company. Conducts more complex negotiations and drafts documents. Assists in preparing financial projections and conducting analysis as required.

Requirements

BA/BS degree and a minimum of 3 years’ experience in contracting, provider relations, provider servicing; or any combination of education and experience, which would provide an equivalent background.
Travels to worksite and other locations as necessary.

Nice To Haves

Provider billing and coding experience preferred.
Single Case Agreement experience preferred.

Responsibilities

Develops the provider network through contract negotiations (language and rates), relationship development, and servicing.
Contracts and negotiates contract terms.
Works with less-complex to complex providers.
Works on cross-functional projects requiring collaboration with other key areas.
Serves as a communication link between professional providers and the company.
Conducts more complex negotiations and drafts documents.
Assists in preparing financial projections and conducting analysis as required.